Account Manager IV

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us.

We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

This position is responsible for retaining existing accounts and selling additional product lines, where appropriate and profitable, within the National market segment. The Account Manager for the National Large Group market serves as the primary relationship manager for assigned to national accounts. This role is responsible for account retention, operational excellence, and strategic support across complex national groups. The Account Manager acts as a trusted advisor to the client and consultants while coordinating across internal Horizon teams to ensure service delivery, compliance, and performance expectations are met.

• Manage contract renewals, including negotiating terms and approving contract modifications outside standard guidelines to support retention and growth.
• Assess client needs and recommend appropriate products, including identifying opportunities to sell additional lines of business.
• Serve as the day-to-day account lead, maintaining consultative relationships with administrators, TPAs, brokers, and consultants.
• Represent Horizon at trustee meetings, board meetings, and client requested forums.
• Proactively manage client expectations and elevate issues as appropriate to ensure timely resolution.
• Partner with Data & Reporting teams to deliver client specific reporting and performance insights.
• Experience with ASO groups both Full Administration and Shared Administration.
• Coordinate internally with Service, Claims, Provider Contracting, Network, Finance, Compliance, IT, and Vendor partners to resolve complex issues.
• Develop and conduct client and group workshops related to enrollment, claims procedures, and healthcare industry regulations.
• Analyze relevant factors and outcomes to make binding financial, operational, and service-related decisions.
• Ensure accounts and brokers are informed of applicable legislative and regulatory updates and their impact.
• Perform additional duties as assigned by management.

• Education/
  
  Experience:
  
  High School Diploma or GED required.
• Bachelor’s degree preferred, or equivalent relevant experience in lieu of a degree.
• Minimum of ten (10) years of account management experience with increasing responsibility, including strategic client relationship management, contract negotiation, and renewal optimization, preferably within the health insurance industry.
• Sales and/or Account Management experience within National Large Group markets strongly preferred.
• Experience conducting service performance, contractual obligations, and performance guarantees where applicable.
• Experience with renewal strategy, including plan design changes, pricing discussions (in partnership with Sales), and benefit modifications.
• Additional licensing, certifications, registrations:
  Requires a New Jersey State Health/Life License.
• Knowledge:
  Advanced proficiency in personal computers and Windows-based software, including Microsoft Word, Excel, and PowerPoint; familiarity with intranet and internet applications.
• Knowledge of National/Large group segments.
• Understanding of group health product lines, including Managed Care.
• Knowledge of rating processes and policy renewal practices.
• Preferred knowledge of Horizon BCBSNJ products, underwriting policies, enrollment, billing, and claims processing procedures.

• Strong negotiation skills.
• Ability to tailor communication and messaging to various audiences.
• Ability to effectively leverage limited engagement opportunities with key decision-makers.
• Capability to…